Background:: The aim of our study was to develop a test setup combining realistic force transmission with physiological movement patterns at a frequency that mimicked daily use of the elbow, to assess implants in orthopedic joint reconstruction and trauma surgery. Methods:: In a multidisciplinary approach, an in vitro biomechanical testing machine was developed and manufactured that could simulate the repetitive forceful movement of the human elbow joint. The construction involved pneumatic actuators. An aluminum forearm module enabled movements in 3 degrees of freedom, while motions and forces were replicated via force and angular sensors that were similar to in vivo measurements. Results:: In the initial testing, 16 human elbow joint specimens were tested at 35 Nm in up to 5000 cycles at a range of 10° extension to 110° flexion. The transmitted forces led to failure in 9 out of the 16 tested specimens, significantly more often in females and small specimens. Conclusions:: It is possible to construct a testing machine to simulate nearly physiological repetitive elbow motions. The prototype has a number of technical deficiencies that could be modified. When testing implants for the human elbow with cadaver specimens, the specimen has to be chosen according to the intended use of the implant under investigation.